| NPI | 1184442485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE MARY GOGGINS Owner 208-867-5066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-26 |
| Last Update Date | 2024-11-12 |